In theatre on the war against disease in Abu Dhabi

Dr Delos Cosgrove, the Cleveland Clinic chief executive.

Dr Delos Cosgrove has performed more than 22,000 operations in his time and today presides over a US$5 billion (Dh18.36bn) healthcare empire that extends to Abu Dhabi.

The Cleveland Clinic chief executive is overseeing the creation of a 360-bed hospital in the capital due to open next year.

As a surgeon in the US Air Force during the Vietnam War, he was awarded a bronze star.

Now he has set his sights on taking the fight against disease to the capital and here he talks about his hopes.

q&a

Where will you source your medical staff for the hospital?

We'll probably have 3,000 employees. The physician and nursing leadership will be Cleveland Clinic. About a third of the physicians should be from Cleveland in the United States and the rest will be sourced from as many places as we can find great docs.

What are your research strengths?

Our cardiovascular is very strong, the second is cancer and the third is diabetes. We are concerned that, as the world gets older, the incidence of degenerative neurological disease is beginning to become a huge issue. For instance in the US we now know if you live to be 80, you have a 25 per cent chance of having Alzheimer's disease. So recognising the brain is the last frontier of research. We have put together a major centre for brain health, looking particularly at Alzheimer's and testing drugs to delay or reverse [it].

What are the challenges involved in setting up in Abu Dhabi?

The whole world is searching for the right way to cost effectively deliver health care. If you look at what is going on in Europe they are going increasingly to privatisation. If you look at the US it's going just the opposite way. Abu Dhabi is straddling both and trying to figure the correct balance and model. There's a level of expectation from the Government and a level of expectation from patients, and I think a lot of those have to coalesce around what becomes the most cost effective way of delivering care.

Is your organisational focus on treatment or research?

The name is on the door. We are the Cleveland Clinic. We are not the Cleveland Research Institute or the Cleveland University. We're like a tricycle; the big wheel is the clinical care, the two supporting wheels are research and education. I don't think you can teach until you establish the capacity to look after people well and teach other people to do it … [or] do research until such time as you have the patients on which to base your clinical research, so the big wheel has to come first.

How hard has the transition been from the US to the Arabian Gulf?

It is a challenging area to work. What we like about Abu Dhabi is the desire to do things appropriately and well and continue to improve. We think the pendulum is moving in the right direction - there's no question about that. Is it the US or western Europe? No. But it is in a process of becoming increasingly flexible. It is pretty stunning when you consider this is a country that is only 40 years old.

How should this region tackle chronic illnesses such as diabetes?

The big push has to be around education and public health. If you don't, if people don't understand about smoking, the need for exercise or eating appropriately, then the incidence of diabetes will continue to go up. In the US right now, 10 per cent of the healthcare costs are secondary obesity and in 10 years we expect it to be 20 per cent of healthcare costs. So unless we can control … obesity we will [not] control the cost of health care. In the US we are leading the way in getting fat. At least we're leading the way in something.